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Politics & Government
Sent Away is an investigative reporting partnership between KUER, The Salt Lake Tribune and APM Reports, with support from the Corporation for Public Broadcasting.

Utah Treatment Centers Would Face Limits On Use Of Restraints, Drugs, Isolation Rooms Under New Bill

A collage of photos shows an inspection report and several youth residential treatment facilities.
Courtesy of the Salt Lake Tribune
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Salt Lake Tribune
Youth residential treatment centers in Utah have faced increasing scrutiny in recent months.

This story discusses suicide. If you or people you know are at risk of self-harm, the National Suicide Prevention Lifeline provides 24-hour support at 1-800-273-8255.

Today in Utah, teens in treatment can be locked in a room for hours, forced to sit in uncomfortable positions, drugged or physically held down as a form of punishment. When this happens, there’s often not a record of it.

Utah state Sen. Mike McKell, R-Spanish Fork, wants to change that. He introduced a bill Monday that would greatly enhance the oversight of these businesses, limit what staffers could do to punish young people, make them document when they do use restraints and provide parents with more information.

It has early support from an industry group and some activists.

If passed, S.B. 127 would also dramatically increase reporting and inspection requirements on these treatment centers that attract patients from across the country. “There’s a lot of money in this industry. It’s a large, large industry,” McKell said. “And I have become increasingly concerned that the appropriate amount of regulation has not caught up.” Utah is currently home to nearly 100 private youth residential treatment programs. In 2015, the Kem C. Gardner Policy Institute surveyed 59 of those programs and found the industry generated $423 million toward the state’s gross domestic product that year alone. McKell said his concerns about the industry stem from cases he has seen as a private attorney. He also had a family member who suffered a traumatic brain injury while working at a program. McKell added recent media attention and public advocacy have also raised legislators’ interest.

As written, the bill would bolster oversight regarding the use of physical restraints and seclusion of students. It would require treatment centers to document any instance in which staff used those techniques and submit monthly restraint reports to the Office of Licensing, which is the industry’s primary regulator in Utah. It would also prohibit programs from sedating residents or using mechanical restraints, like a straightjacket, without the office’s prior authorization.

The bill includes a new non-discrimination framework. This would require Department of Human Services programs to refer to individuals using their preferred pronouns and ban dress codes related to biological sex.

It would also raise the number of inspections each facility receives to four per year — up from one.

“The goal is to ensure the viability of the industry but do it in a way that protects the residents,” McKell said.

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Rick Egan/The Salt Lake Tribune
Sen. McKell’s bill includes new suicide prevention requirements for residential treatment programs in Utah. A resident at West Ridge Academy in West Jordan died by suicide in 2020.

The last time Utah lawmakers passed a significant new regulation on this industry was in 2005, when it required background checks for staffers.

The Department of Human Services, which oversees the Office of Licensing, declined to comment on the specifics of the proposed legislation. A spokesperson said the department is “always open to improvements and protections afforded in the law to support our mission.”

McKell’s bill comes in the wake of increasing scrutiny of the so-called “troubled teen” industry in Utah. This past autumn, there was a rise in activism against industry abuse, including social media campaigns, a rally and online petitions.

One of the driving forces behind that activism was the online movement Breaking Code Silence, fueled by former residents of these treatment centers who feel they were mistreated. The group’s top government relations coordinator, Caroline Lorson, applauded the bill as a step in the right direction but said further measures will be needed.

“There’s still a lot more work to do,” she said, “But I think breaking through that immediate resistance that a lot of industry has to regulation is going to be the toughest battle.” Lorson added that state level regulation is the most important way to increase transparency and protect young people.

McKell, the bill’s sponsor, said he will begin meeting with therapy businesses this week — including Provo Canyon School and the National Association of Therapeutic Schools and Programs. The industry group’s executive director, Megan Stokes, praised the bill’s focus on suicide prevention, which includes a new risk assessment for young people. But she also said her organization wants to see more specificity around certain terms in the bill, such as “essential program service,” “personal interaction,”and “emotional response.” “We are in support of this bill with a couple of amendments,” she said in a statement. “We thank Senator McKell for drafting this important first step and look forward to the legislative session.”

Editor’s note: KUER and The Salt Lake Tribune are collaborating on a reporting project about Utah’s youth residential treatment centers.

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